Healthcare Provider Details
I. General information
NPI: 1336305051
Provider Name (Legal Business Name): HERBERT MARTIN ZERTH III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/01/2008
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
220 SPRINGFIELD DR STE 100
BLOOMINGDALE IL
60108-2215
US
IV. Provider business mailing address
PO BOX 713260
CHICAGO IL
60677-1260
US
V. Phone/Fax
- Phone: 888-693-6437
- Fax: 630-946-2363
- Phone: 630-469-9200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | 125052982 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 036.124517 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: